MCQS 319-321:A 30 year-old woman relates an 8 month history of recurrent pruritic skin lumps. Endoscopy eveals a duodenal bulb ulcer


A patient with hemoglobin M disease is exposed to nitrites and develops cyanosis. This is best treated with

a) ethanol
b) naloxone
c) physostigmine
d) atropine
e) methylene blue
f) diphenhydramine
g) calcium disodium ethylene diamine tetraacetic acid
h) deferoxamine mesylate
i) flumazenil
j) Folic acid


A 30 year-old woman relates an 8 month history of recurrent pruritic skin lumps. She also complains of recent episodes of facial flushing and lower abdominal pain. Endoscopy eveals a duodenal bulb ulcer. urine histamine levels are raised. Biopsy of one of the lumps would most likely reveal

a) target cells
b) melanocytes
c) lymphoblasts with clumped chromatin
d) transitional epithelial cells
e) mast cell infiltration
f) neutropenia
g) Burr cells
h) squamous epithelial cells
i) anti-nuclear antibodies
j) clumps of neutrophils


A 4 year old girl has had red eyes for one week. She has no discharge, photophobia or any other ocular symptoms. On examination vision is normal ,the pupils are equal and reactive, both conjunctivae are markedly injected. She is noted to have prominent cervical lymphadenopathy and her lips appear dry and chapped. Her tongue is very red and enlarged. Her hands are reddened A possible diagnosis is

a) Complicated otitis media
b) Carotid-cavernous fistula
c) orbital pseudotumor
d) pancoast Tumor
e) mucocele
f) Kawasaki's disease
g) ophthalmic artery obstruction
h) Lyme disease
i) thyroid ophthalmohathy
j) cluster headache


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